Fluid resuscitation in live Escherichia coli shock in puppies

Bacteremia-induced suppression of alveolar surfactant production

Sepsis is characterized by Adult Respiratory Distress Syndrome (ARDS)-like pulmonary dysfunction largely attributed to alveolar capillary endothelial cell injury which causes increased microvascular permeability and interstitial edema formation. In addition, quantitative and qualitative abnormalities of the pulmonary surfactant system may be important features of some clinical and experimental lung injuries. This study was designed to investigate the relationship of bacteremia and endotoxemia to pulmonary surfactant production in vivo. A technique for estimation of pulmonary surfactant phospholipid synthesis measuring incorporation of a stable isotope precursor [( 2-13C]acetate) into dipalmitoylphosphatidylcholine (DPPC) in alveolar lavage fluid was developed. Male 350 g Sprague-Dawley rats had placement of central venous catheters. After overnight recovery, sublethal bacteremia (Escherichia coli, 1 x 10(8) organisms, iv) and sublethal endotoxemia (Difco; 10 mg/kg, iv) were induced. Both were associated with lung microvascular permeability increases consistent with capillary endothelial injury. Eight-hour infusions of [2-13C]acetate were given. After sacrifice, bronchoalveolar washings and lung tissue were obtained and [2-13C] incorporation into lavage and lung DPPC was measured by gas chromatography mass spectroscopy. Endotoxin-treated animals had a 21.5% reduction in label incorporation into DPPC [1.215 +/- 0.145 APE (%) sham versus 0.954 +/- 0.144 APE (%) experimental, P greater than 0.05] and bacteremic animals had a 56.9% diminution of [2-13C]acetate incorporation [1.215 +/- 0.145 APE (%) sham versus 0.524 +/- 0.56 APE (%) experimental, P less than 0.05]. Bacteremia-induced dysfunction of alveolar type II epithelial cells manifested as diminished alveolar surfactant phospholipid production may be a contributing factor to sepsis-induced respiratory failure.

Necrotizing enterocolitis: treatment based on staging criteria

Neonatal necrotizing enterocolitis is the most important cause of acquired gastrointestinal morbidity or mortality among low birthweight infants. Prematurity alone is probably the only identifiable risk factor. Although the etiology is unknown NEC has many similarities to an infectious disease. Proper staging helps improve reporting and the management of NEC.

The metabolism of an exogenous lipid source during septic shock in the puppy

Septic shock induces physiologic and hemodynamic responses that may alter the host's ability to metabolize an exogenous source of lipids. The present study examined the metabolic changes occurring during septic shock in the young animal receiving an intravenous fat emulsion. Five 8-wk-old male Beagle puppies were studied. Each animal served as his own control twice, during which time 14C-palmitic acid alone or with a 10% fat emulsion (Liposyn) was administered. Septic shock (cardiac output less than 50% of control) was induced with an intravenous bolus of live Escherichia coli. During shock the puppies received intravenous 14C-palmitic acid and Liposyn. The mean respiratory quotient for the shock dogs (0.96 +/- 0.01) was significantly (p less than 0.05) higher than that of the controls (0.83 +/- 0.06). The amount of expired 14CO2 was 25.0 +/- 15.9% for the shock animals, 53.9 +/- 28.1% for the Liposyn controls, and 75.7 +/- 30.5% for the controls receiving only 14C-palmitic acid (these differences are all significant, p less than 0.05). After the onset of shock, serum triglyceride levels peaked within 2 min at 851 +/- 540 mg/100 ml and remained elevated at 333 +/- 213 mg/100 ml. Triglyceride levels in the Liposyn control animals returned to baseline values (54 +/- 13 mg/100 ml) at the end of the 4-hr experimental period. Free fatty acids in the shock dogs reached a maximal level of 1.44 +/- 0.09 mEq/liter at 1 hr and remained at this elevated value for a significantly longer period of time than in the Liposyn control puppies. Glycerol value followed a similar pattern and cholesterol remain unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)